| Ashley Ridge Medicine, Llc | |
|
1015 Obrie St Zwolle LA 71486-2510 | |
| (318) 645-6161 | |
| (318) 645-6168 |
| Full Name | Ashley Ridge Medicine, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1015 Obrie St, Zwolle, Louisiana |
| Authorized Official Name and Position | Chi Tai Peter Lau (PHYSICIAN / PROVIDER / OWNER) |
| Authorized Official Contact | 3186456161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Ridge Medicine, Llc Po Box 5313 Shreveport LA 71135-5313 Ph: (318) 645-6161 | Ashley Ridge Medicine, Llc 1015 Obrie St Zwolle LA 71486-2510 Ph: (318) 645-6161 |
| NPI Number | 1922294784 |
|---|---|
| Provider Enumeration Date | 09/14/2007 |
| Last Update Date | 03/26/2015 |
| Medicare PECOS PAC ID | 2860580818 |
|---|---|
| Medicare Enrollment ID | O20071108000670 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922294784 | NPI | - | NPPES |
| 1494909 | Medicaid | LA | |
| DG4348 | Other | LA | RAILROAD MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 23409 (Louisiana) | Primary |
| Provider Name | Chi Tai P Lau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750340592 PECOS PAC ID: 9931167509 Enrollment ID: I20050311000626 |
Zwolle Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2114 Obrie Street, Zwolle, LA 71486 Phone: 318-645-4484 Fax: 318-645-9139 | |
Desoto Regional Health System Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2026 Obrie Street, Zwolle, LA 71486 Phone: 318-645-6013 | |
Zwolle Express Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1015 Obrie St, Zwolle, LA 71486 Phone: 318-645-6168 Fax: 318-645-6168 |